Healthcare Provider Details

I. General information

NPI: 1255377172
Provider Name (Legal Business Name): PATRICIA ANN HUBBELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA ANN ALLPHIN HUBBELL MD

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W CENTRAL AVE
DELAWARE OH
43015-1421
US

IV. Provider business mailing address

500 W CENTRAL AVE
DELAWARE OH
43015-1421
US

V. Phone/Fax

Practice location:
  • Phone: 740-363-1904
  • Fax: 740-363-5288
Mailing address:
  • Phone: 740-363-1904
  • Fax: 740-363-5288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.043057
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: